The Importance of Up-Cycling
One of the points I presented during my latest webinar about Osteoarthritis, but which applies to ALL chronic pain is this: progress shows up in two ways. The first and more obvious sign of progress is a reduction in pain. Less pain is usually what people are hoping for and where all their efforts lie. This is totally understandable, but what often happens is the focus on pain reduction causes us to overlook the second, and incredibly valuable sign of progress: increase in function.
Let's take an example scenario. Everyday you experience, give or take, a level 4 out of 10 pain in your left hip. It makes you limp and keeps you from being able to walk up the stairs or get down on the floor. After a few weeks (maybe a couple of months) of physical therapy, strength training, or other coaching, your pain hasn't really changed from that level 4. BUT, you can now walk up the stairs semi-comfortably, you no longer limp, and you've gotten down and up off the floor a couple of times as needed. That's a HUGE measure of progress in your quality of life.
I have a client, we'll name her Laurel. Laurel has been experiencing debilitating lower body pain for a few months that has caused her quality of life to downward spiral. She told me she barely gets out of the house anymore. After the first couple of sessions, we made a plan for her to go outside at least once a day and walk to the end of her block and back.
When I saw her the following week, she was disappointed. After diligently doing some movement and going out on a walk everyday, she was still in a lot of pain. I asked her, "Didn't you leave the house more this past week than you've been able to do in previous weeks?" She half nodded as if slightly hesitant to agree. I said, "That's progress! Even though it feels small, you increased your function this week by going outside and taking a walk every single day." I watched her face as she decided whether or not to believe my good news interpretation of her past week.
Pain is incredibly sensitive to a cyclical effect and the cycle can either move in a positive direction or a negative direction. Everyone wants no pain. But in the event that the pain relief process is sloooooow and stubborn, it's wise to start pouring your attention onto your level of function, because increasing your function can very easily up-cycle. Let's go back to the hip and stairs example. If you can walk up the stairs again, you're more likely to continue walking up the stairs, and possibly try other movements. If you're aware of this progress, you're likely to experience increased levels of confidence about your situation. The higher the confidence, the more functional activity you're willing to try. The more activity you engage in, the higher the confidence and on and on -- and it's within this process that the re-wiring of the pain experience begins. Eventually, your pain levels may decrease as a secondary effect of your focus on the increase in your function.
keep moving.